Healthcare Provider Details

I. General information

NPI: 1598897209
Provider Name (Legal Business Name): STEPHEN C JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 E. NEW CIRCLE RD
LEXINGTON KY
40505
US

IV. Provider business mailing address

1351 NEWTOWN PIKE
LEXINGTON KY
40511-1217
US

V. Phone/Fax

Practice location:
  • Phone: 859-721-6810
  • Fax: 859-721-6815
Mailing address:
  • Phone: 859-253-1686
  • Fax: 859-254-2743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number162485
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: